Studies on the dynamics of transmission of onchocerciasis in a Sudan-savanna area of North Cameroon V. What is a tolerable level of Annual Transmission Potential?

The prevalence and intensity of infection with Onchocerca volvulus were assessed in population surveys in nine villages, situated at different distances from Simulium damnosum s.l. breeding sites. The prevalence varied from 48 to 89%, the arithmetic mean densities of microfilariae per skin snip were between 16 and 109, and severe ocular lesions were found in from 1 to 22% of patients. Annual Transmission Potentials (ATP) were measured for up to three years in the near vicinity of nine villages at several fly-catching sites. Weighted means of the ATP over the three years, and of the sojourn times of the human population, were calculated at three of the villages, where the prevalence of onchocerciasis was 51, 61 and 89%. An average ATP of 100 larvae or less in the head, thorax and abdomen of the flies was associated with an onchocerciasis prevalence of 50 to 60%, a mean microfilarial density below 40 microfilariae per skin-snip, less than 5% of ocular lesions, and no onchocercal blindness. This value might therefore be considered to be an indication of the level to which the transmission must be reduced in the savanna in order to prevent the occurrence of severe ocular lesions or blindness. It is lower than the present level accepted by the Onchocerciasis Control Programme in the Volta River Basin.